Long term results of arthrodesis of the wrist: A 6–15 year follow up of 35 patients

Abstract

A total of 40 wrists in 35 patients were investigated 10.5 (range 6-15) years after arthrodesis. The most common diagnosis was rheumatoid disease. There were 21 Mannerfelt, and 21 plate, arthrodeses. The patients were assessed clinically and up-to-date radiographs obtained. Two Mannerfelt arthrodeses had failed to fuse. Pain during the last week before review and total satisfaction with the operation were excellent in 28 and 30 wrists, respectively. The mean score on the "Disability of arm, shoulder and hand" (DASH) questionnaire was 38 (range 2-75). Plate arthrodeses gave better results than Mannerfelt arthrodeses for all variables studied. Wrists plated in dorsal extension gave the best scores for function and strength. We conclude that either method gives good long term results. Although few of the individual differences were statistically significant, we think that fusion with plates, and in particular plates with dorsal extension, is preferable.

Universal Total Wrist Arthroplasty: Midterm Follow-Up Study

“…4,28 The most important problem of an arthrodesis is the difficulty in performing activities of daily living, such as fastening buttons, picking up objects from the floor, and performing perineal hygiene. 16,26,29,30 Although patients become accustomed to the loss of wrist motion after a period of a few months, when asked for their preferences, they usually prefer an arthroplasty over an arthrodesis. 3,12,31 One reason to consider arthroplasty in patients with rheumatoid arthritis is multiple joint involvement.…”

“…16,[23][24][25][26][27] However, some postoperative complications have been reported, such as tendon adhesions or friction against the dorsal plate and screws, requiring removal of the hardware and causing nonunion and fractures. 4,28 The most important problem of an arthrodesis is the difficulty in performing activities of daily living, such as fastening buttons, picking up objects from the floor, and performing perineal hygiene.…”

Management of Complications of Wrist Arthroplasty and Wrist Fusion

“…It can also be used as a salvage procedure for failed limited wrist fusions as well as partial or total wrist arthroplasties. Studies have generally shown excellent results with long-term outcomes following wrist arthrodesis (23,24).…”

Biomechanical Studies on Hand Function in Rehabilitation

“…DASH has been used for evaluating the effectiveness of patient-oriented hand rehabilitation programmes, and has shown significant differences between two rehabilitation programmes and surgery (Gummesson, Atroshi et al 2003;Harth, Germann et al 2008). Furthermore, DASH has been used by Solem et al (2006) for evaluation of long-term results of arthrodesis (Solem, Berg et al 2006). Adams et al (2004) showed in their study that DASH was useful to evaluate the relationship between upper limb functional ability and structural hand impairment (Adams, Burridge et al 2004).…”